The Medical Minute: Shin splint complaints soar in spring

If shin splints are keeping you from making the most of your runs this spring, you're not alone. Shin splints—pain in the front of the lower legs—is a common affliction of those who exercise regularly, and an ailment that especially affects runners. According to Dr. Matthew Silvis, associate professor of family medicine and orthopaedics at Penn State Hershey, shin splints are among the most common complaints this time of year for people back on the road or trail after a long winter.

Many high school and college track and field programs start in the spring, giving young athletes the opportunity to take their training back outside. There are many other people who run summer, fall and spring take the winter months off, relying instead on indoor exercises like cross training, an elliptical, spinning/cycling, or even treadmill running to keep up their conditioning. That is good from a cardiovascular standpoint. But such exercises don't put the same impact on the legs that running does.

“Many people feel that because they've been exercising during the winter they can get out there when the weather improves and go at it pretty hard,” Silvis says. “But running puts more strain on the legs than most other exercises, and that's what can lead to shin splints.”

The term shin splints generally refers to pain and soreness along the shinbone, or tibia, the largest bone of the lower leg. The pain comes from overuse of the muscles and tendons around the bone. That additional or unusual stress on and around the shinbone causes it to become inflamed and sore.

Silvis says it's important to give the body time to adjust when changing an exercise routine. For runners, he suggests not increasing mileage or duration by more than 10 percent from one week to the next: If you run 15 miles this week, don't run more than 16.5 miles the next week, for example. Doing too much too soon can bring on shin splints, which, if untreated, can lead to a more serious injury—stress fracture.

Stress fractures—tiny cracks in the bone—typically come from overuse. Beyond causing discomfort and requiring a runner to back off her routine for a few days or a few weeks, a stress fracture can seriously sideline the athlete and the casual runner alike.

“For people who love to run, love being active, the last thing they want is to not be able to run for a long period of time,” Silvis says. “That's why it's important to pay attention to your body and give it the time it needs to adapt and recover before pushing it to do more.”

To prevent shin splints, Silvis recommends:

• Gradually increasing the amount or intensity of a workout to avoid too much stress on the legs.
• Following a regular, gentle stretching routine that includes the calves, because inflexibility of the muscles around the shinbone can be a culprit of causing shin splints.
• Wearing well-fitting, supportive athletic shoes. Runners should replace their shoes every 300 to 500 miles to ensure proper support and cushioning for feet and legs.
• Balance running workouts with other training that isn't as stressful on the legs, such as cycling, cross-training or swimming.

If you're already dealing with shin splints this spring, icing the area can help, as can an over-the-counter anti-inflammatory medicine if needed for pain. Wait to return to your activity until you're pain-free for two weeks.

If you're doing all the right things and still find yourself battling shin splints, Silvis says it may be time to consider an orthopaedic evaluation to check for things like improper alignment or flat feet, among others.

The Medical Minute is a weekly health news feature brought to you by Penn State Milton S. Hershey Medical Center. Articles feature the expertise of Penn State Hershey faculty physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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